233 Underrecognised and Undermanaged: A Snapshot of Cancer Cachexia Awareness in Surgery

Abstract Aim Cancer cachexia affects up to 80% of patients with advanced malignancy and is linked to poorer surgical outcomes and increased mortality. Despite its prevalence, it remains under recognised in surgical settings. Recent international consensus emphasises the urgent need for systematic identification and management of cachexia across all oncology settings, including surgery. This study assessed surgical ward staff awareness, understanding, and confidence in managing cancer cachexia. Method An anonymous cross-sectional survey was distributed to staff on surgical wards at Torbay Hospital in April 2025. The questionnaire included multiple choice and free text questions addressing the definition of cachexia, red flags, guideline familiarity, referral practices, and perceived barriers. Results A total of 31 staff members completed the survey, including doctors (52%), nurses (26%), allied health professionals (10%), including dietitians. Experience levels ranged from <1 year (32%) to >10 years (26%).97% correctly identified the clinical definition of cachexia.Only 35% recognised the correct threshold of 5% unintentional weight loss over six months as a red flag.Regarding clinical behaviour, only 32% had previously referred a suspected cachexia patient to a dietitian.80% felt education would be useful, and 61% saw value in a clearer referral pathway. Conclusions Staff working on surgical wards demonstrated significant gaps in knowledge and confidence around the identification and management of cancer cachexia. Despite widespread clinical impact, cachexia remains under-recognised in this setting. These findings support targeted educational interventions and the introduction of structured screening prompts into the surgical pathway.